A prospective cohort study evaluating subjective and objective neurosensory changes following LeFort I osteotomy

Area of Science:

• Oral and Maxillofacial Surgery
• Neurosurgery
• Plastic Surgery

Background:

• LeFort I osteotomy can lead to neurosensory deficits (NSD).
• Understanding NSD incidence, recovery, and influencing factors is crucial for patient care.

Purpose of the Study:

• To investigate the incidence and recovery of NSD after LeFort I osteotomy over 12 months.
• To identify associations between age, gender, surgical movement, and NSD recovery.
• To explore relationships between objective and subjective NSD outcome measures.

Main Methods:

• Prospective cohort study of 31 patients undergoing LeFort I osteotomy.
• Objective assessments: pinprick, static light touch, 2-point discrimination, electric pulp testing.
• Subjective assessments: visual analog scale for NSD impact on intraoral and extraoral sites.
• Follow-up at baseline, 1 week, 1, 3, 6, and 12 months post-surgery.

Main Results:

• NSD incidence reduced from 85.7% at 1 week to 17.9% at 12 months.
• No significant differences in NSD based on gender or extent of surgical movement at 12 months.
• Age was a significant factor for immediate intraoral NSD, but not long-term.
• Subjective patient concerns regarding NSD decreased over time.

Conclusions:

• NSD is frequent post-LeFort I osteotomy, especially intraorally.
• Recovery occurs within 3-6 months for most sites, with maxillary dentition recovery up to 12 months.
• Age, gender, and surgical extent do not influence 12-month NSD; intraoral NSD causes greater patient concern initially.